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  • 1
    Online Resource
    Online Resource
    The heterogeneity of headache patients who self-medicate: a cluster analysis approach
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Pain Vol. 157, No. 7 ( 2016-07), p. 1464-1471
    Details
    In: Pain, Ovid Technologies (Wolters Kluwer Health), Vol. 157, No. 7 ( 2016-07), p. 1464-1471
    Abstract: Patients with headache often self-treat their condition with over-the-counter analgesics. However, overuse of analgesics can cause medication-overuse headache. The present study aimed to identify subgroups of individuals with headache who self-medicate, as this could be helpful to tailor intervention strategies for prevention of medication-overuse headache. Patients (n = 1021) were recruited from 202 community pharmacies and completed a self-administered questionnaire. A hierarchical cluster analysis was used to group patients as a function of sociodemographics, pain, disability, and medication use for pain. Three patient clusters were identified. Cluster 1 (n = 498, 48.8%) consisted of relatively young individuals, and most of them suffered from migraine. They reported the least number of other pain complaints and the lowest prevalence of medication overuse (MO; 16%). Cluster 2 (n = 301, 29.5%) included older persons with mainly non-migraine headache, a low disability, and on average pain in 2 other locations. Prevalence of MO was 40%. Cluster 3 (n = 222, 21.7%) mostly consisted of patients with migraine who also report pain in many other locations. These patients reported a high disability and a severe limitation of activities. They also showed the highest rates of MO (73%).
    Type of Medium: Online Resource
    ISSN: 0304-3959 , 1872-6623
    URL: Article
    DOI: 10.1097/j.pain.0000000000000541
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1494115-6
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  • 2
    Online Resource
    Online Resource
    Home Medication Cabinets and Self-Medication: A Source of Potential Health Threats?
    SAGE Publications ; 2008
    In:  Annals of Pharmacotherapy Vol. 42, No. 4 ( 2008-04), p. 572-579
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 42, No. 4 ( 2008-04), p. 572-579
    Abstract: Data regarding the contents of home medication cabinets (HMCs), the management of leftover medications, and the inclination of patients toward self-initiated treatment using nonprescription drugs are scarce. OBJECTIVE: To evaluate the nature and safety of medication storage and intended self-medication in a general population. METHODS: A cross-sectional study was conducted in 72 Belgian community pharmacies. Pharmacy customers (N = 288, aged 18–80 y) were visited in their homes by pharmacy students. The HMCs were inventoried and the participants were interviewed. RESULTS: A mean of 31 ± 17 (range 6–136) drug packages were identified per household; in one-third of the cases, the packages were not stored safely. Prescription drugs accounted for 34% of the total. The most frequently encountered categories of registered medicines were nonopioid analgesics (7.2%), nonsteroidal antiinflammatory drugs (NSAIDs) (6.9%), nasal decongestants (3.5%) and antinausea agents (3.2%). Despite their high prevalence, NSAIDs and non-opioid analgesics did not predominate among the most frequently used drugs, whereas food supplements were used daily in 23.3% of households. Twenty-one percent of the drugs were expired, 9% were not stored in the original container, and the package insert was missing for 18%. Self-initiated treatment was considered for 56% of all drugs (over-the-counter drugs, 74%; prescription drugs, 21%). Indication, dosage, or treatment duration was misjudged by only 5.2% of the participants, but consulting the package insert was allowed. The tendency toward self-treatment decreased with age and with increasing number of medications taken daily (p = 0.002). CONCLUSIONS: We found large amounts of drugs per household, with a high prevalence of analgesics and NSAIDs. Self-medication, although generally acceptable in terms of indication and dosage, was commonly practiced, also with prescription drugs. Taking into account that younger people showed a significantly higher intention of self-medication, a sustained awareness of the risks of self-medication is warranted for the future.
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1345/aph.1K533
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2053518-1
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  • 3
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    COPD Management in Primary Care: An Observational, Community Pharmacy–Based Study
    SAGE Publications ; 2010
    In:  Annals of Pharmacotherapy Vol. 44, No. 2 ( 2010-02), p. 257-266
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 44, No. 2 ( 2010-02), p. 257-266
    Abstract: Chronic obstructive pulmonary disease (COPD) is a prevalent disease that is frequently treated in primary care. However, data regarding the primary care management of COPD are scarce. Such observational data are necessary to detect problem areas and to develop targeted interventions for improvement of COPD management. Objective: To provide a detailed description of (1) drug therapy, (2) drug adherence, (3) inhalation technique, and (4) health status of patients with COPD recruited via community pharmacies. Methods: A cross-sectional, observational study was conducted in 93 pharmacies in Belgium. Participants (N = 555) completed a questionnaire collecting information on personal characteristics, smoking history, influenza vaccination, COPD medication, and adverse effects. Adherence to COPD maintenance medication was analyzed 1 year retrospectively through prescription refill rates. Inhalation technique was scored using a checklist. Health status was evaluated with the St. George's Respiratory Questionnaire, the Clinical COPD Questionnaire, and the Modified Medical Research Council dyspnea scale. Results: The mean age of the patients was 68.6 years; 73.7% were men and 37.2% were current smokers. The influenza vaccination status was significantly lower in patients aged less than 65 years (65.7%) than in patients aged 65 years or more (86.2%) (p 〈 0.001). Fixed combinations of inhaled corticosteroids and long-acting β2-agonists were the most frequently used COPD medications (75.4%). About 48% of patients were underadherent ( 〈 80% adherence), 47% were adherent (80–120% adherence) and 5% were overadherent ( 〉 120% adherence). Predictors for underadherence were age and number of drugs. Twenty-one percent of patients made major inhalation technique errors with rescue medication; these were all errors in handling pressurized metered-dose inhalers (pMDIs). Conclusions: This observational study on COPD management in primary care highlights 4 main aspects that could be improved: (1) drug adherence, (2) inhalation technique with pMDIs, (3) influenza vaccination in COPD patients younger than 65 years, and (4) smoking cessation.
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1345/aph.1M481
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
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  • 4
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    Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease ( PHARMACOP ): a randomized controlled trial
    Wiley ; 2014
    In:  British Journal of Clinical Pharmacology Vol. 77, No. 5 ( 2014-05), p. 756-766
    Details
    In: British Journal of Clinical Pharmacology, Wiley, Vol. 77, No. 5 ( 2014-05), p. 756-766
    Abstract: Few well‐designed randomized controlled trials have been conducted regarding the impact of community pharmacist interventions on pharmacotherapeutic monitoring of patients with chronic obstructive pulmonary disease ( COPD ). We assessed the effectiveness of a pharmaceutical care programme for patients with COPD . Methods The pharmaceutical care for patients with COPD ( PHARMACOP ) trial is a single‐blind 3 month randomized controlled trial, conducted in 170 community pharmacies in B elgium, enrolling patients prescribed daily COPD medication, aged ≥50 years and with a smoking history of ≥10 pack‐years. A computer‐generated randomization sequence allocated patients to an intervention group ( n = 371), receiving protocol‐defined pharmacist care, or a control group ( n = 363), receiving usual pharmacist care (1:1 ratio, stratified by centre). Interventions focusing on inhalation technique and adherence to maintenance therapy were carried out at start of the trial and at 1 month follow‐up. Primary outcomes were inhalation technique and medication adherence. Secondary outcomes were exacerbation rate, dyspnoea, COPD ‐specific and generic health status and smoking behaviour. Results From D ecember 2010 to A pril 2011, 734 patients were enrolled. Forty‐two patients (5.7%) were lost to follow‐up. At the end of the trial, inhalation score [mean estimated difference (Δ),13.5%; 95% confidence interval ( CI ), 10.8–16.1; P 〈 0.0001] and medication adherence (Δ, 8.51%; 95% CI , 4.63–12.4; P 〈 0.0001) were significantly higher in the intervention group compared with the control group. In the intervention group, a significantly lower hospitalization rate was observed (9 vs . 35; rate ratio, 0.28; 95% CI , 0.12–0.64; P = 0.003). No other significant between‐group differences were observed. Conclusions Pragmatic pharmacist care programmes improve the pharmacotherapeutic regimen in patients with COPD and could reduce hospitalization rates.
    Type of Medium: Online Resource
    ISSN: 0306-5251 , 1365-2125
    URL: Issue
    URL: Article
    DOI: 10.1111/bcp.2014.77.issue-5
    DOI: 10.1111/bcp.12242
    RVK:
    XA 33650
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 1498142-7
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  • 5
    Online Resource
    Online Resource
    Self-Medication With Over-the-Counter Analgesics: A Survey of Patient Characteristics and Concerns About Pain Medication
    Elsevier BV ; 2019
    In:  The Journal of Pain Vol. 20, No. 2 ( 2019-02), p. 215-223
    Details
    In: The Journal of Pain, Elsevier BV, Vol. 20, No. 2 ( 2019-02), p. 215-223
    Type of Medium: Online Resource
    ISSN: 1526-5900
    URL: Article
    DOI: 10.1016/j.jpain.2018.09.003
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2040378-1
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  • 6
    Online Resource
    Online Resource
    Self-Medication in Persistent Rhinitis: Overuse of Decongestants in Half of the Patients
    Elsevier BV ; 2014
    In:  The Journal of Allergy and Clinical Immunology: In Practice Vol. 2, No. 3 ( 2014-05), p. 313-319
    Details
    In: The Journal of Allergy and Clinical Immunology: In Practice, Elsevier BV, Vol. 2, No. 3 ( 2014-05), p. 313-319
    Type of Medium: Online Resource
    ISSN: 2213-2198
    URL: Article
    DOI: 10.1016/j.jaip.2014.01.009
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2014
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  • 7
    Online Resource
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    Medication Administration in Nursing Homes: Pharmacists' Contribution to Error Prevention
    Elsevier BV ; 2010
    In:  Journal of the American Medical Directors Association Vol. 11, No. 4 ( 2010-5), p. 275-283
    Details
    In: Journal of the American Medical Directors Association, Elsevier BV, Vol. 11, No. 4 ( 2010-5), p. 275-283
    Type of Medium: Online Resource
    ISSN: 1525-8610
    URL: Article
    DOI: 10.1016/j.jamda.2009.10.013
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2010
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  • 8
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    Self-Medication of Upper Gastrointestinal Symptoms: A Community Pharmacy Study
    SAGE Publications ; 2009
    In:  Annals of Pharmacotherapy Vol. 43, No. 5 ( 2009-05), p. 890-898
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 43, No. 5 ( 2009-05), p. 890-898
    Abstract: Upper gastrointestinal (GI) symptoms are a common reason for self-treatment with over-the-counter (OTC) medication. However, data are scarce on the typology of GI complaints for which individuals seek self-medication and, more importantly, on the prevalence of alarm symptoms in this population. Objective To investigate: (1) the nature of GI symptoms that people intend to self-medicate, (2) prevalence of alarm symptoms, (3) adherence to referral advice given by the pharmacist, and (4) self-reported efficacy and frequency of use of OTC medication for minor complaints. Methods This descriptive study was performed in 63 community pharmacies. Participants (N = 592, aged 18–82 y) completed a questionnaire to assess symptom characteristics and previous medical consulting. Based on this information, the pharmacist referred subjects to a physician or advised self-treatment. Four weeks later, participants were presented a follow-up questionnaire evaluating their adherence to referral advice or efficacy of self-treatment. Results The most frequently reported GI symptoms were burning retrosternal discomfort (49.2%), acid regurgitation (53.2%), and bothersome postprandial fullness (51.2%). At least one alarm symptom was present in 22.4% of the individuals, with difficulty in swallowing being the most prevalent (15.4%). Although 21% of the customers were referred, only 51.7% of these contacted a physician. Almost all (95.1%) of the remaining customers who were advised self-treatment reported symptom relief with the OTC drug obtained. Conclusions Mild GI symptoms will mostly resolve with self-treatment. Yet, the value of pharmacist counseling on OTC treatment should be recognized, as community pharmacists can play an important role in distinguishing symptoms that warrant further medical examination.
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1345/aph.1L647
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2053518-1
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  • 9
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    Effective Interventions for Diabetes Patients by Community Pharmacists: A Meta-analysis of Pharmaceutical Care Components
    SAGE Publications ; 2018
    In:  Annals of Pharmacotherapy Vol. 52, No. 2 ( 2018-02), p. 198-211
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 52, No. 2 ( 2018-02), p. 198-211
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1177/1060028017733272
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2053518-1
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  • 10
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    HOW SAFE IS ON-LABEL DRUG USE IN PAEDIATRICS? THE CASE OF FIRST GENERATION H1-ANTIHISTAMINES
    BMJ ; 2016
    In:  Archives of Disease in Childhood Vol. 101, No. 1 ( 2016-01), p. e1.58-e1
    Details
    In: Archives of Disease in Childhood, BMJ, Vol. 101, No. 1 ( 2016-01), p. e1.58-e1
    Abstract: For obvious reasons, much attention has recently been paid to off-label prescriptions in paediatrics. However, on-label prescribing can cause health issues too: we discuss the case of first generation H1-antihistamines (FGAs). These have been in use for over 70 years, for a variety of indications such as relief of allergic conditions, cough and insomnia. Materials and methods The FGAs were listed using their International Nonproprietary Names (INN). For each formulation, the information of the Summary of Product Characteristics issued in five selected European countries (Belgium, France, Germany, the Netherlands and United Kingdom) was collected. This was plotted against the published evidence on efficacy and safety of each FGA. Results 16 different FGAs are currently marketed in single-drug oral preparations in the evaluated countries. When investigating each drug separately, a huge variability in labelled indications, licensing age for paediatric use, and availability characteristics in the different countries is observed. Most of the indications are not supported by evidence from published clinical trials. Conclusion Both health care professionals and consumers generally assume that all approved H1-antihistamines have been shown to be efficacious and safe, but many in this class – in particular those introduced before 1985 – have not been optimally studied. This might explain the inconsistencies in indications and licensing ages of the evaluated drugs in different countries. Moreover, many of the antihistamines are sold over the counter, which may contribute to overuse. Such overuse can be a serious problem, as sedation is a known side effect of all FGAs.
    Type of Medium: Online Resource
    ISSN: 0003-9888 , 1468-2044
    URL: Article
    DOI: 10.1136/archdischild-2015-310148.61
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 1481191-1
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